DEAR DR. DONOHUE: I am a 64-year-old female writer who hikes her dog for an hour daily, swims three times a week and plays tennis weekly. Often I cannot sleep at night because my toes cramp up. As a result, I am sleep-deprived. Sometimes during the day, the little fingers on both hands cramp up, but not when I type on the computer.

My doctor tells me that cramping complaints are common in middle-aged women. Soaking in the hot tub before bed seems to help. Any advice you can give will be appreciated. – E.S.

ANSWER: A cramp is an involuntary, often painful muscle contraction. I am speaking of cramps not due to heat or exercise, but ones that come out of the blue, often at night. For most, a cause isn’t found. Low blood levels of sodium, potassium, calcium and magnesium can sometimes lead to cramping. People on water pills can develop a potassium deficiency and muscle cramping. Misfiring nerves and circulatory problems are other, rare possibilities. Diabetes and thyroid disturbances can bring cramps.

Dehydration is a more common cause. Drinking a glass or two of water in the evening can prevent dehydration-induced cramps. It doesn’t hurt to try the water remedy. The only downside is the chance of having to get out of bed during the night to empty your bladder. If you really want to experiment and there is no reason you shouldn’t be taking minerals like sodium, then substitute a sports drink for water. Gatorade is an example, but it’s only one of many. These drinks contain most of the minerals whose depletion brings cramps.

Stretching exercises before going to bed prevent cramps. If people don’t have a hot tub, a warm bath also works.

I can’t explain your little-finger cramps. Perhaps it’s one of the unusual illnesses called dystonias, where sustained muscle cramps are the salient feature. Writer’s cramp, the contraction of the muscles holding a pen or pencil, is one dystonia. Although rare, this is something you can mention to your doctor for his or her opinion.

The booklet on restless leg syndrome and muscle cramps covers both topics in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 306, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: As a longtime fan of your medical column, I would like to ask you a question that interests millions of men. I have lots of baldness on both sides of my family. My hair has really thinned out at age 60. Is there anything affordable that the average man can purchase and take internally to stop balding and rejuvenate hair? – A.H.

ANSWER: Propecia is a prescription, oral drug that can restore hair growth for some men. A month’s supply is about $55.

Rogaine, a liquid applied directly to the scalp, is available without a prescription. It costs around $21 a month. It also comes as the generic minoxidil for $15.

Both require a lifelong commitment. Hair gained is lost if a person stops treatment. Neither gives a man a lion’s mane of hair. The growth, when it happens, is better described as “modest.”

DEAR DR. DONOHUE: My 15-year-old son lost a testicle. Will his growth be normal, and will he be able to father a child? – H.F.

ANSWER: Your son’s growth should be normal. One testicle can supply all the male hormone he needs. If it appears he’s lagging behind boys his age, then it’s relatively easy to check whether supplemental hormone is needed.

The same goes for fertility. Men with one testicle almost never have trouble having children. In the days before mumps vaccine, mumps in postpubertal boys and in men often inflamed the testicles and left one nonfunctioning. These boys and men almost never had fertility or growth problems.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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